Tickers

A man got on a train the other day, coffee in one hand, a copy of What Car magazine in the other. He worked as an accounts clerk at a packaging firm in Slough. He had a wife and kids and a dog called Barney. He liked CSI Miami and drinking dirty martinis in the rain.

He never did get to finish that coffee.

When his heart failed, the explosion claimed the lives of fifteen other commuters. The rail authorities were cleaning up blood and body parts for days. It played havoc with the train schedules.

For Pippa Withers though, it was just another day on the front line.

Pip was an O.R. nurse in the cardiology department of St Mary’s, Bristol. The unit occupied an entire wing of the hospital, sealed off from the main building by a fifty-foot walkway dubbed ‘The Red Mile’. The building itself was a reinforced concrete breezeblock, smack bang in the middle of town. The wards were fortified with shatterproof windows and steel-enforced doors. The walls were painted red to hide the stains, and pre-op patients were kept in lead-lined cubicles.

Nothing was left to chance.

Front line medical staff wore Kevlar blast suits; colour coded according to rank – blue for nurses, green for doctors, red for surgeons. No-one wore white anymore; it was too impractical. The Kev-suits were sectional, overlapping like a carapace for maximum protection. This made them difficult to manoeuvre in and, due to the combination of Kevlar, foam and plastic, they were incredibly hot too. This often resulted in heat stress, which, if left unchecked could lead to illness and disorientation, reducing the wearer’s ability to accomplish the task in hand. A daunting prospect when they’re elbow-deep in the chest of a ‘live’ patient.

Kev-suits were issued without gloves. This enabled the medical team to maximise dexterity and precision, but it also meant that their hands and forearms were completely unprotected. Pip knew of at least three surgeons, and two nurses, who had been forced to take early retirement because their arms had been blown off during a routine procedure. Blast lung too was a common hazard, affecting orderlies and admin staff mostly because all they had to protect them were ballistic aprons and helmets – budget cuts and all that.

As a result, cardiology was a crucible most people avoided. Staffing levels were at an all-time low. It was a dirty job and no mistake, but someone had to do it – cardiology was where people went to get their transplants.

Since the Cataclysm, mechanical hearts had become mandatory. Biology could not be trusted. Hearts were like hand grenades and a matter for the MoD. When a citizen turned sixteen, they received a summons to attend hospital. Surgeons in Kev-suits would painstakingly remove their dodgy tickers and pass the pulsing pumps to EOD officials for detonation in gas-tight blast chambers.

Some people though ignored their summons.

People like the man on the train.

People like Pip’s mother.

Pip had spent years trying to persuade Mrs Withers to have the transplant, but the woman was not for turning. Pip’s visits became less frequent as her mother grew older. When she did make the trip down to St Columb Minor, Pip wore a ballistic vest and helmet.

Last month Mrs Withers had what she called a ‘funny turn’. It was just a dizzy spell she said, perhaps the salmon tartlet she’d eaten at Malcolm Fraser’s wake (even though it smelled a bit off and she didn’t particularly like fish), but Pip knew the signs. Mrs Withers was primed for detonation.

Pip had to get her mother to the hospital: STAT.

She stopped off at a service station on the road to St Columb Minor and bought her mother a bunch of carnations and a box of marzipan fruits. When she got back to the car, Pip put the flowers on the back seat and opened the box of marzipans. She placed the upturned lid on her lap and fished through her bag for the Slumbadyne she had stolen from the hospital’s dispensary earlier that day. She had chosen the sedative for its ability to put a person under in a very short time, and to keep them under for a very long time. Long enough for Pip to do what had to be done. Slumbadyne also tasted like almonds, which was perfect for lacing marzipan fruits. Using a biro, she scooped a hole in the base of an apple and set the excess paste aside. Next, she popped a tablet from the blister pack, crushed it and tipped the powder into the hole. Pip then re-plugged the hole with the paste and set it aside. She did this for each fruit in the box (except the bananas as the shape was less accommodating). When she was finished, Pip placed the sweets on the seat beside the flowers and phoned Michael to let him know that she would be late home.

Pip arrived at her mother’s cottage a little after three in the afternoon. The sun hung hot and heavy above a glittering sea. Mrs Withers was in the front garden, tending her prize-winning roses. The Dutch Gold, she’d told Pip during her last visit, had been given a special mention by the Royal Horticultural Society while the Abraham Darby, a new addition to her collection, was in need of some attention; apparently it had succumbed to black spot soon after planting and had not yet recovered. Mrs Withers loved her floribundas and her hybrid teas it was true, but she took no prisoners when it came to pruning, lopping withered heads with clinical precision. She had set her sights on the Black Baccara – a deep red tea rose that looked almost black from certain angles – when Pip pulled up and cut the engine. The Black Baccara was Pip’s favourite, but today the dark blooms reminded her of little hearts, plopping unceremoniously into the basket at Mrs Withers’ feet.

Pip’s shirt was sticking to her skin when she put on her ballistic vest. The Kevlar bore down on her shoulders like an iron shroud, but compared with her blast suit it was like slipping into a silk blouse. She took a moment to compose herself, then pulled the helmet down over her head, grabbed the gifts, and got out of the car.

“What time do you call this?” Her mother demanded, not bothering to turn around.

“Sorry mum,” Pip said. “The traffic was a nightmare.”

Mrs Withers scowled at her. “Why do you have to wear those things?” She asked. “I’m not going to pop my clogs any time soon, you silly girl.”

A bead of sweat rolled down Pip’s cheek. “You can’t be too careful, mum. I have to think about Greg and Samantha. Be thankful it’s just a vest and helmet. I could have worn my Kev-suit.” In reality, the hospital wouldn’t have permitted her to take the suit. Kev-suits were shared between shifts and someone else would be wearing it right now. Pip had bought the vest from an armourer’s up-town.

“At least take off that ridiculous helmet,” Mrs Withers said.

Pip eyed her mother through the visor, considering. Mrs Withers had a good colour and seemed chipper enough, so Pip pulled the helmet off and slung it under her arm. Truthfully, she was glad of the fresh air. A sea breeze ruffled Pip’s hair and her skin prickled.

“How are my grandchildren?” Her mother asked.

“They’re fine,” Pip told her. “Greg starts school in a few weeks.”

Mrs Withers sighed. “They grow up so fast.”

“Yes,” said Pip. “They do.” She felt a pang of guilt for not bringing the kids to visit their grandmother. It was a regretful act but a necessary one. Pip couldn’t risk her children.

“Well, come on then, let’s get the kettle on.” Her mother dropped the secateurs into the basket and waddled inside. When Pip didn’t follow, she turned back. “Well, what’s keeping you? The tea won’t make itself you know.”

“Coming mother.” Pip followed Mrs Withers inside, clutching the box of marzipan fruits to her chest and wishing things were different.

The cottage was a childhood memory captured in the spiralling scents of lavender and lentil soup wafting from the kitchen, in the teak-panelled walls that threw long shadows across the hall floor, and in the busy flora of the threadbare carpet that swam beneath Pip’s feet in a swirling abstraction of deep greens and golden browns. It was in the Doulton figurines that lined every surface, looking down at Pip now with accusatory expressions on their little glazed faces. The décor hadn’t changed in decades, not since Pip was a child, and probably never would as long as her mother was around. Pip had offered to decorate, many times, but her mother was adamant that the cottage didn’t need it. ‘It’s fine the way it is’, she would say, and that would be the end of that.

The kitchen was drowning in a sea of blue gingham. From chair cushions and window dressings to tea towels and oven mitts, and when there was no more room for it, gingham gave way to starched white cotton and scalloped lace. A huge black crock pot bubbled on the stove, spilling forth aromas of ham and onion that made Pip’s stomach grumble. Colourful planters brimming with geraniums lined the windowsill like chorus girls and porcelain cats of every breed and colour lounged on shelves between oddments and utensils.

Her mother’s face lit up at the sight of the miniature fruits. “Oh,” she said, grabbing them out of Pip’s hand. “My favourite.” She smiled. “Thanks Pippi.”

Her mother’s glee made Pip’s stomach churn. “You’re welcome,” she said. “Now, how about that tea?” She ushered her mother to a chair and started filling the kettle. She threw three teabags into a teapot shaped like a ginger tomcat and glanced over her shoulder. Mrs Withers was demolishing her second marzipan, seemingly unaware of the little surprise at its centre.

“I love these,” she said. “You don’t get them round here you know.”

Pip filled the teapot with boiling water and put it on the table, then pulled two mugs from the shelf above the toaster and placed them next to it. She fetched the sugar from the pantry and milk from the fridge, grabbed a couple of teaspoons from the drawer and took a seat beside her mother.

She filled the mugs with steaming tea and handed one to Mrs Withers. “There you go, mum.”

“Didn’t you make me Earl Grey? I usually have Earl Grey at this time of the day. I like an Earl Grey, with a squeeze of lemon. Lovely. Why didn’t you make me Earl Grey you silly girl?”

Pip stopped stirring her tea and looked up at her mother. “Since when did you drink Earl Grey?”

“I’ve always drank it.”

“No, you haven’t. I’ve never seen you with anything but regular tea. Milk and two, since time immemorial.”

“That’s not true, I’ve always enjoyed a late afternoon Earl Grey. Shows how much you know, and you’re supposed to be a nurse.”

“Well it’s made now, I suppose.” Mrs Withers sipped her tea and grimaced. “Definitely better in a cup though.” She put the mug back on the table and reached for another marzipan. Pip was beginning to regret drugging so many of them. She hadn’t accounted for her mother’s voracious appetite. At this rate, Mrs Withers would overdose before Pip could get her to the operating table.

“Why don’t you try a banana?” Pip asked.

“I hate bananas,” said her mother, taking a bite of an almond flavoured orange. “Oh, where are my manners. Would you like one dear?” She offered the box to Pippa.

Pip smiled and took a banana. “Thank you.”

Mrs Withers tossed the rest of the orange into her mouth and reached for another.

“So,” Pip said. “What’s new with you? Still playing bridge with Vera?”

Mrs Withers looked Pip in the eyes. Her own were rheumy and shot with blood. “Will I feel it, do you think?”

“No,” said Pip. She knew exactly what her mother meant. “Your brain won’t have time to register the pain.” Mrs Withers looked relieved. Pip saw a chance, and she took it. If she could get her mother to go to Bristol willingly, she could dispense with the whole ‘Sparkling Cyanide’ act. “It doesn’t have to be this way you know.”

Her mother nodded. Was she agreeing?

“It’s not too late,” Pip continued. “I could take you back tonight. In a couple of days you-”

“No,” said Mrs Withers, reaching for another marzipan. “Don’t fix what isn’t broken. That’s what your father used to say.”

Donald Withers had suffered a heart attack three months before the Cataclysm. He had simply lost consciousness, slipping away in Pippa’s arms while they waited for the ambulance to arrive. There was no explosion, no bloodbath, and no casualties, except for him. Donald was the reason behind Pip’s decision to become a nurse. Pip wanted to save lives, not destroy them, but her mother was as stubborn as the stains on the O. R. walls.

“It’s the government you know,” said Mrs Withers.

“What’s the government?”

“The Cataclysm. It’s all the government’s doing. Mark my words. They did it so they could control us with those mechanical hearts of theirs.” She leaned close. “I heard they programme them to last exactly fifty years, and if we’re older when we get the op, they reduce the years so we’ll all die at the same age.”

“That’s rubbish,” said Pip. “No they don’t.”

“It’s not rubbish,” Mrs Withers insisted, slamming her hand on the table. “They want to free up hospital beds and rob us of our pensions! Think about it, we’re all living longer, and they’re always banging on about the costs of geriatric care. Just look at the pension crisis! I’m telling you they’re trying to do us in so they can save money!” She poked a finger at Pip. “Guess how old Vera was.”

“I don’t know mum, seventy-something?”

“Sixty-six. Guess how old Tom Jeffries was?”

“Who’s Tom Jeffries?”

“A friend from the salsa club. It doesn’t matter. Just guess.”

“Salsa club?” Pip’s mother gave her a withering look. “Okay, okay. Sixty-six, by any chance?”

“Yes! And Betty Fulham, and Bill Donahue. All sixty-six when they died. Explain that.”

“A coincidence.”

“How can you say that? You want me to have the transplant, but you’re still not getting it. You still don’t understand. I’m seventy-two, Pippa. Don’t you see? If I’d had the op, I’d be dead by now!

“Oh mum, that’s not true.”

“And if I go with you to Bristol now, they’re not going to give me a heart. I’ve already had six years more than I should have. They’re going to kill me!”

Pip sighed. “They’re not going to kill you.”

Mrs Withers flung her hands in the air. “How can you be so sure?”

“I’m a cardiology nurse, mum. I assist in transplants every day.”

Mrs Withers was fond of conspiracy theories, though she wasn’t usually this passionate about them. Could she have a point? Pip knew very little about the hearts they put into people, her own included, and no-one knew how the Cataclysm happened. One day everything was normal, and the next, people were self-combusting all over town. There was no proof that the government caused the Cataclysm, but there was no proof that they didn’t either. Would Pip die at sixty-six, just like Vera Marshall? Would her kids? Pip dismissed the notion as absurd. The government weren’t bumping people off just so they could save a few quid. It was a ridiculous idea. Mrs Withers was just being paranoid, and paranoia was a side-effect of Slumbadyne.

“Perhaps you shouldn’t eat so many marzipans mum,” Pip said, pulling the box out of her mother’s reach. “You know how they can upset you.”

Mrs Withers snatched the box back and threw another fruit into her mouth. She looked like a petulant schoolgirl. “You bought me them. Stop trying to…” She paused then spat the half-chewed marzipan into her hand. “This one tastes flummy.”

Flummy?

“Mum?” Pip put her mug down. “Are you okay?”

Slumbadyne often induced slurred speech and disorientation as well as paranoia and Mrs Withers had turned an ashen shade of sage. She looked at Pip now with a mixture of confusion and suspicion. She took a closer look at the half-eaten marzipan.

“Mum wait,” said Pip, trying to grapple it out of her mother’s hand.

Mrs Withers pulled the marzipan apart, exposing the white powder at its centre. Her expression darkened. “Christ,” she said, standing. “You’re trying to poison me!” She shook her head. “You’re… you’re in on it!”

“In on it? Mum…” Pip got to her feet. “You’re going to be okay.” She took a step towards her mother.

Mrs Withers snatched a knife from the sink and waved it at Pip. “Stay back!”

Pip did as her mother asked. “Mum, calm down. I’m not going to hurt you.”

“Mum listen to me, you need to calm down,” Pip pleaded. “I’m not trying to kill you. I’m trying to help you. I’m going to take you St Mary’s. It’s for your own good.”

“My own good? Who do you think… you’s… talkim..?”

“Mum?”

Mrs Withers began to gasp. “Can’t… breathe.” She dropped the knife and stumbled backwards. Pip rushed over and caught her mother as she fell.

Something was wrong.

Mrs Withers began to convulse, vomiting marzipan chunks all over the kitchen tiles.

Something was terribly, terribly wrong.

Mrs Withers’ breathing was laboured and erratic. Pip felt her pulse. It was racing; over two hundred BPM, indicating a V-tec. Pip broke into a cold sweat. Ventricular tachycardia was a life-threatening arrhythmia, a nuclear warhead in a heart-shaped box, and Pip had just pressed the big red button.

Pip dropped her mother’s hand and staggered back. “Christ,” she said. “What have I done?”

She pulled on her helmet and began rummaging through her bag, looking for her mobile. When she realised she must have left it in the car, she went looking for her mother’s landline, but Mrs Withers had a habit of leaving her phone in the most peculiar places, and when Pip finally found it (on the bathroom windowsill), the battery was dead.

When Pip returned to the kitchen, Mrs Withers was in cardiac arrest.

“Mum!” Pip flew to her mother’s side and started performing compressions. “Come on mum,” she pleaded, but Mrs Withers was unresponsive. Pip needed to get help, and fast. She needed a defibrillator, and a shot of adrenalin. She needed an Amiodarone drip and Dr Aziz, but her mobile was in the fucking car and if she left her mother to get it, Mrs Withers would die. If she stayed, no-one would come, and Mrs Withers would die.

And so would Pip.

Pip knew what she should do. She should get as far from her mother as possible. Mrs Withers was a ticking time bomb and her time was fast running out.

Tick, tick, tock. Tick, tick, tock…

Dizzy with fear and indecision, Pip began pumping furiously on her mother’s chest. She couldn’t leave her behind. How could she live with herself after that?

Don’t’ fix what isn’t broken.

“Oh mum.” Pip pulled the helmet off and let it drop. “You were right.” She drew Mrs Withers into her arms and held her close, stroking her silver hair as if she were a child in need of soothing. “You’re always right.”

As her mother slipped away Pip thought of her father and wondered if he would be there to meet his wife and daughter when the clock finally stopped.

Tick tick, tock…

Pip thought of Michael and the kids.

Tick. Tick…

“Forgive me.”

Tock.

A woman walked into a cottage on the cliffs at St Columb Minor the other day. She worked as a nurse at St Mary’s Hospital, Bristol, passed over for promotion time and time again by younger, more promising candidates. She wasn’t bitter, though. All she wanted to do was save lives. She had a husband and two kids, and a cat named Smokey. She liked dancing, and pizza and watching Mary Poppins on Christmas Day. When the cottage went up, the explosion registered 5.6 on the Richter scale and sent ten feet of cliff plunging into the Celtic Sea.